This is a finished NUR 506 Module 3 search strategy paper for a question on warm perineal compresses in labor, with concepts and terms, full search strings, a search log table, screening decisions, the sources kept and references. Searches like "nur 506 module 3 assignment", "nur506 module 3 search strategy paper" and "nur 506 module 3 example" land here.
The NUR 506 Module 3 example, in full
A Search Another Nurse Could Repeat: Documenting the Evidence Search on Warm Perineal Compresses in Second-Stage Labor
[Student Name]
Southern New Hampshire University
NUR 506: Evidence-Based Practice
Module Three Search Strategy Paper
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
A Search Another Nurse Could Repeat: Documenting the Evidence Search on Warm Perineal Compresses in Second-Stage Labor
The Question and Its Concepts
On a composite 22-bed labor and delivery unit, midwives routinely apply warm compresses to the perineum during pushing, while some nurses and physicians do not, and the unit has no guideline. The question guiding this search is: in women giving birth vaginally (P), does applying warm compresses to the perineum during the second stage of labor (I), compared with no compresses (C), reduce third- and fourth-degree perineal tears (O) at birth (T)?
The question contains three searchable concepts: vaginal birth or the second stage of labor, warm compresses, and perineal trauma. The comparison and time are used to judge relevance during screening rather than as search terms. Searching for concepts rather than for the whole question keeps the search broad enough to find studies that describe the same thing in different words.
Search Terms and Combination
For each concept, the search used both subject headings and keywords. For labor, the headings Labor Stage, Second in PubMed and Labor Stage, Second in CINAHL were combined with keywords such as second stage, pushing and vaginal birth. For warm compresses, no specific heading exists, so keywords were used: warm compress, warm pack, hot compress and heat, with truncation such as compress* to capture compress and compresses. For perineal trauma, the headings Perineum and Obstetric Lacerations (PubMed) and Perineal Injuries (CINAHL) were combined with keywords including perineal tear, laceration, obstetric anal sphincter injury and OASIS.
Synonyms for the same concept were linked by OR so that any of them would retrieve a record, and AND then required all three concepts to appear together. Phrases were placed in quotation marks. Limits were kept to a minimum: English language and publication from 2000 onward. No study design filter was applied at first so that systematic reviews, trials and guidelines would all appear.
Refining the Strategy After the First Run
The first PubMed search, run before this log was finalized, used only the keyword warm compress and returned 11 records, several of them letters and commentaries. Reviewing the relevant records showed why the search was too narrow. Australian researchers used the term warm pack, some trials described the intervention as hot compresses, and many studies indexed their outcome under obstetric lacerations rather than perineal tears. Each of these terms was added to the strategy, which raised the PubMed result to 41 records with a much higher share of trials. Reading the subject headings assigned to two known relevant studies, a technique sometimes called pearl growing, was the quickest way to find the vocabulary that indexers had used.
A second refinement concerned outcomes. An early version of the search included pain and satisfaction as a fourth concept, but that excluded trials that reported perineal outcomes and not comfort. Because severe tears are the primary outcome, the pain concept was removed from the search and pain was treated as a secondary outcome to note during screening. Documenting these changes matters, because a reader who sees only the final strategy cannot tell which decisions shaped it.
Search Log
The table below records the searches exactly as run. Reporting guidance for literature searches recommends documenting each database, platform, date, full strategy and limits so that a search can be reproduced (Rethlefsen et al., 2021).
Table 1
Search Log for Warm Perineal Compresses
| Source | Date | Strategy summary | Limits | Results |
|---|---|---|---|---|
| PubMed | Sept 8 | (second stage OR pushing OR Labor Stage, Second[MeSH]) AND (warm compress* OR warm pack* OR hot compress*) AND (perine* OR Obstetric Lacerations[MeSH]) | English; 2000 to present | 41 |
| CINAHL Complete (EBSCO) | Sept 8 | Same concepts with CINAHL Headings Labor Stage, Second and Perineal Injuries | English; 2000 to present | 36 |
| Cochrane Library | Sept 9 | warm compress AND perineal | None | 4 reviews; 18 trials |
| Guideline sources | Sept 9 | Professional body websites searched for perineal care guidance | None | 3 |
| Reference lists | Sept 10 | Hand search of included review | None | 2 additional |
Note. Full strings, exactly as entered, are saved in the appendix of the student's search file.
Screening the Results
After duplicates were removed, 68 unique records remained. Titles and abstracts were screened against three criteria: the study included women having a vaginal birth, it tested warm compresses applied during the second stage, and it reported perineal trauma outcomes. Studies of perineal massage during pregnancy, of cold packs after birth for pain, and of episiotomy technique were excluded. Twelve records remained for full-text review, and seven were retained: one Cochrane systematic review, four randomized controlled trials and two clinical guidance documents. The flow from records identified to records included was recorded in a diagram following the structure of the PRISMA reporting guideline, adapted for a practice question rather than a full systematic review.
The Key Sources Found
The most important source is a Cochrane review of perineal techniques during the second stage of labor. It included 22 trials and found that warm compresses made no clear difference to the chance of an intact perineum, but that fewer third- and fourth-degree tears were reported with warm compresses, with the evidence rated as moderate quality (Aasheim et al., 2017). One of the included trials, conducted in two Sydney hospitals with 717 first-time mothers, found fewer third- and fourth-degree tears with warm packs and reported that women and midwives found the packs comforting (Dahlen et al., 2007). These sources will be appraised in detail in the next module.
Limits of the Search and Next Steps
The search has limits. Restricting to English may have missed trials from non-English-speaking countries, where some perineal research has been done. Only two bibliographic databases were searched; adding Embase and a trials register would reduce the chance of missing unpublished studies. Keywords for the intervention were chosen by the nurse and may have missed terms such as warm towel or heated pad. Before appraisal, a health sciences librarian will review the strategy, and one additional search will be run using the missed terms and a trials register.
Conclusion
This search translated a clinical question about warm compresses into three concepts, combined subject headings and keywords with Boolean logic, and recorded every step so that another nurse could reproduce it. It identified a Cochrane review and several trials suggesting that warm compresses may reduce severe perineal tears. The documentation, rather than the number of results, is what makes the search trustworthy and ready for appraisal.
References
Aasheim, V., Nilsen, A. B. V., Reinar, L. M., & Lukasse, M. (2017). Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Systematic Reviews, (6), Article CD006672. https://doi.org/10.1002/14651858.CD006672.pub3
Dahlen, H. G., Homer, C. S., Cooke, M., Upton, A. M., Nunn, R., & Brodrick, B. (2007). Perineal outcomes and maternal comfort related to the application of perineal warm packs in the second stage of labor: A randomized controlled trial. Birth, 34(4), 282-290. https://doi.org/10.1111/j.1523-536X.2007.00186.x
Rethlefsen, M. L., Kirtley, S., Waffenschmidt, S., Ayala, A. P., Moher, D., Page, M. J., Koffel, J. B., & PRISMA-S Group. (2021). PRISMA-S: An extension to the PRISMA statement for reporting literature searches in systematic reviews. Systematic Reviews, 10, Article 39. https://doi.org/10.1186/s13643-020-01542-z
How this NUR 506 Module 3 example is structured
A search paper is judged on whether it can be repeated, so it is organized like a method section. It opens with the question and its concepts. The next section lists search terms for each concept and explains how they were combined. A search log table records the databases, dates, strings, limits and counts. The screening section explains inclusion and exclusion criteria and follows the results down to the final set. The paper closes with the key sources found, the limits of the search and what a second search would add.
Get NUR 506 Module 3 written to your instructions
Send your NUR 506 search assignment, the rubric and your PICOT question. A search paper documented to that question is written within 24 to 48 hours, and the first sample is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
NUR 506 Module 3 questions, answered
What does a NUR 506 search strategy assignment usually require?
Expect to name the databases you searched, your keywords and subject headings, how you combined them with Boolean operators, the limits you applied and the number of results at each step. Many prompts also ask how you selected the final sources. Your classroom instructions set the exact elements.
What makes a literature search reproducible?
Recording everything another person would need to repeat it: each database and platform, the date searched, the full search string exactly as entered, every limit applied and the number of results. Reporting guidance for searches recommends documenting all of these details.
Should I include both keywords and subject headings?
Yes. Subject headings, such as MeSH in PubMed or CINAHL Headings, find articles indexed on a concept even when authors use different words, while keywords find recent articles not yet indexed and terms the headings miss. Combining both gives a more complete search.